When was the last time a loved one mentioned they had been suffering from scurvy, rickets, beriberi, or pellagra? Contrast that with the frequency by which those you know who may be on medications for high blood pressure, high cholesterol, or blood sugar regulation, or they are simply struggling to lose weight. Even after over 14 years as a dietitian, I have never come across a person with a disease of nutritional deficiency. Yet, my practice is flooded with people suffering from chronic foodborne illnesses, such as cardiovascular disease, type 2 diabetes, and obesity. And even despite these diagnoses, many of these same people are still concerned about their diet lacking in nutrients.
Diet recently surpassed smoking as the number one cause of early death and disability in the United States.  And then, just this year, a study in The Lancet came to the same conclusion, but at a global level.  Chronic overnutrition is now not only a problem; it is the primary problem when it comes to health across the world. As of 2016, the CDC  reports 40 percent of adults and 18.5 percent of youth in the U.S. as overweight and obese, and almost 2 billion adults and more than 380 million children around the globe are overweight or obese, according to the WHO. 
Despite these shocking statistics, we are still striving to get enough and nutrition is almost exclusively based upon a premise of inadequacy. This can be illustrated by the continual bombardment of headlines voicing concerns about “getting enough protein,” pushing the consumption of more meals throughout the day, and misleading label claims on foods peppered throughout the grocery store highlighting the nutritional mastery found in that package. Some of my favorite examples include protein-infused water (and vodka, for that matter), zero-carb bread, and the promotion of chocolate milk for its calcium. (And for that matter, a gluten-free, vegan, paleo, chocolate hazelnut candy bar or “organic, free-range, 100% natural” canned chicken chunks masquerading as health foods? >SIGH<)
Interestingly, this happens at all different levels, from mainstream media to medical schools, and everywhere in between. The powerful connection between diet and health outcomes is not well understood or even accepted as the viable tool that it is. Physicians are trained to diagnose and then treat that diagnosis with pharmaceuticals or procedures, almost never being taught the dramatic impact diet can have on their patient outcomes.
Some blame the dietetics profession for the currently skyrocketing incidence of obesity.  And I would have to agree. The prime directive in nutrition education and guidelines is to avoid deficiency…almost as if the real-time statistics are being swept under the rug in our modern food environment. Excess is preferred over deficiency, despite the unintended consequences that this mission has ultimately achieved. In a time of scarcity, all of this makes sense – get the most nutrition by any means possible. But we are in an entirely new era, one that is bombarded by surplus, one that offers temptation everywhere. One where gas stations sell food, airplanes serve snacks on any-length flight, and every social gathering is centered around sharing a swallow.
We need a paradigm shift.
It has been quite a journey to finally stop defending a plant-based diet as being adequate, as that was the core of my message as the Plant-Based Dietitian. In lectures, in books and articles, in blog posts, I focused on illustrating just where you can find your [fill-in-the-blank] nutrient so that people would not worry about any potential risk of missing out when eliminating animals from the menu. Once I learned about the mounting evidence [6,7] supporting the hypothesis that less is more when it comes to healthspan and longevity, it became more and more obvious that this may be one of the myriad mechanisms by which eating plants is so extraordinarily advantageous.
Today, I have evolved my message from defending the nutrient adequacy to touting right-side Food Triangle eating as beneficial because of what it is naturally restricted in. Plants are low in or free of saturated fat, essential amino acids, heme iron, cholesterol, carnitine, Neu5Gc, and other health-damaging compounds. What they are abundant in are the two most health-promoting nutrients: fiber and phytonutrients. 
To maximize the principles of healthspan and plant-based nutrition, avoiding overconsumption and optimizing nutrient intake, here are four practical things to consider when planning your diet:
- Prioritize the 6 Daily 3’s so you can achieve the most nutritional bang for the caloric buck (i.e. the most nutrition for the least energy), while enjoying a variety of vegetables, fruits, whole grains, legumes, mushrooms, nuts, seeds, herbs, and spices.
- Remember that less is more. Practice time restricted feeding by limiting the time spent in a fed state.
- Consider covering your bases with a gentle multivitamin and microalgae-based source of the long chain omega-3 fats, EPA and ALA.
- Stay accountable for your health by having regular physicals and monitoring lab work, including those for serum vitamin D, methylmalonic acid (MMA) to assess vitamin B12 status, glucose, and lipid panels, along with whatever your physician recommends. Feel free to share our two peer-reviewed nutrition guides for healthcare professionals:
Plant-Based Diets: A Physician’s Guide (Perm J 2016)
Plant-Based Nutrition for Healthcare Professionals (J Geriatr Cardiol 2017)
- Murray, Christopher JL, et al. “The state of US health, 1990-2010: burden of diseases, injuries, and risk factors.” Jama 310.6 (2013): 591-606.
- Afshin, Ashkan, et al. “Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017.” The Lancet 393.10184 (2019): 1958-1972.
- Hales, Craig M., et al. “Prevalence of obesity among adults and youth: United States, 2015–2016.” (2017).
- World Health Organization, and World Health Organization. “Obesity and overweight fact sheet. 2016.” Department of Sustainable Development and Healthy Environments. Available from: http://www. searo. who. int/entity/noncommunicable_diseases/media/non_communicable_diseases_obesity_fs. pdf. accessed June10 (2018).
- Portman, O. W. and D. M. Hegsted. “Nutrition.” Annu Rev Biochem 26 (1957): 307-326.
- Longo, Valter D., et al. “Interventions to slow aging in humans: are we ready?.” Aging cell 14.4 (2015): 497-510.
- Moroz, Natalie, et al. “Dietary restriction involves NAD+‐dependent mechanisms and a shift toward oxidative metabolism.” Aging cell 13.6 (2014): 1075-1085.
- Hever, Julieanna, and Raymond J. Cronise. “Plant-based nutrition for healthcare professionals: implementing diet as a primary modality in the prevention and treatment of chronic disease.” Journal of geriatric cardiology: JGC 14.5 (2017): 355.